Page 106 - Handbook of Electronic Assistive Technology

Chapter 4 • Assessment and Outcomes 93

In the assessment there are typically several sets of skills/abilities which are observed,
measured or discussed. The following outlines some of the areas which need to be discussed.

Physical Skills

To use any of the EAT equipment discussed within this book one thing must first be estab-
lished. When using the device, the client must be comfortable, stable and can reliably
access the device, wherever they are and whatever the circumstance, not just in the clinic
room where the assessment takes place.
The chapter on posture introduces the reader to the need for a ‘functional posture’.
This would require the assessment team to know:
• Where the user wishes to use the device.
• What seating (postural) equipment they would be using.
• Whether the device would be required in lying or standing.
• How posture changes over time or when moving from one place to another.

Seating assessments in the United Kingdom are undertaken predominantly by wheel-
chair services. The seating and wheelchair bases that clients are provided with might not be
the best position for the activity your client wishes to undertake. Additional support may be
required to enable the person to sit in a posture which makes them ready for function and
stabilises their pelvis and trunk to promote head control and upper limb reach and operation.
Typical measurements taken when assessing for EAT are the range of movement of
arms and legs. Assessment of these factors is undertaken by a range of disciplines. If
not directly undertaking the assessment, observing the assessment gives the opportu-
nity to identify what movements might work if considering operating alternative access
methods, e.g., whether someone has sufficient reliable voluntary movement to effec-
tively operate an adapted keyboard in comparison to operating two switches to scan an
on-screen keyboard.
Gross movement upper limbs: This is of importance if looking to deliver an access
method, i.e., where can a switch be placed where the user can achieve a reliable voluntary
method of operation? Is there sufficient movement such that they can move on and off
the switch as required? How many switches might they use without accidental activation
occurring?
Fine motor movement: Gross arm movements require a lot of energy and can take
longer to complete. Ideally, a smaller movement might be identified, which can be used to
operate a switch or alternative access method.
10
Some key terms associated with defining abilities of fine motor movement include:
Bilateral integration: Using two hands together (e.g., opening a jar with one hand
while the other hand helps by holding the jar).

10 https://childdevelopment.com.au/areas-of-concern/fine-motor-skills/fine-motor-skills/.